Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy.
Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy.
Cytopathology. 2022 May;33(3):305-311. doi: 10.1111/cyt.13113. Epub 2022 Mar 7.
Cytology of serous effusions is an important diagnostic tool for the diagnosis of cancer, staging, and prognosis of the patient. Herein, we retrospectively applied the International System for Reporting Serous Fluid Cytopathology (TIS) and provided the corresponding risks of malignancy (ROMs).
Pleural, pericardial, and peritoneal effusion samples were retrieved from the archives of our department and reclassified according to the TIS. The ROM for each category was calculated based on available surgical follow-up.
A total of 3790 effusions were studied. Pleural samples (1292) were reclassified as follows: 27 (2.1%) as non-diagnostic (ND), 1014 (78.5%) as negative for malignancy (NFM), 86 (6.6%) as atypia of undetermined significance (AUS), 29 (2.3%) as suspicious of malignancy (SFM), and 136 (10.5%) as malignant (M). Pericardial samples (241) were reclassified as follows: 4 (1.6%) as ND, 173 (71.8%) as NFM, 10 (4.1%) as AUS, 7 (3%) as SFM, and 47 (19.5%), as M. Peritoneal cases (2257) were re-categorised as follows: 31 (1.4%) as ND, 1897 (84%) as NFM, 39 (1.7%) as AUS, 53 (2.4%) as SFM, and 237 (10.5%) as M. The respective ROM values for each category were 18.5%, 15%, 45.3%, 93%, and 100% in pleural effusions; 25%, 13.2%, 35%, 100%, and 100% in pericardial effusions; and 19.3%, 10.4%, 43.5%, 100%, and 100% in peritoneal effusions.
Pleural, pericardial, and peritoneal cytology show high specificity and moderate sensitivity in the evaluation of serous effusions. The ROMs reported in our study were mostly concordant with those published according to the TIS.
浆膜腔积液细胞学检查是诊断癌症、分期和预测患者预后的重要诊断工具。在此，我们回顾性应用国际浆膜腔液细胞学报告系统（TIS）并提供相应的恶性肿瘤风险（ROM）。
从我院档案室中检索胸腔积液、心包积液和腹腔积液标本，并根据 TIS 进行重新分类。根据手术随访结果计算每个分类的 ROM。
共研究了 3790 例积液。胸腔积液标本（1292 例）的重新分类结果如下：27 例（2.1%）为非诊断性（ND），1014 例（78.5%）为无恶性肿瘤（NFM），86 例（6.6%）为意义未明的非典型细胞（AUS），29 例（2.3%）为疑似恶性肿瘤（SFM），136 例（10.5%）为恶性肿瘤（M）。心包积液标本（241 例）的重新分类结果如下：4 例（1.6%）为 ND，173 例（71.8%）为 NFM，10 例（4.1%）为 AUS，7 例（3%）为 SFM，47 例（19.5%）为 M。腹腔积液病例（2257 例）重新分类为：31 例（1.4%）为 ND，1897 例（84%）为 NFM，39 例（1.7%）为 AUS，53 例（2.4%）为 SFM，237 例（10.5%）为 M。各分类的相应 ROM 值如下：胸腔积液中分别为 18.5%、15%、45.3%、93%和 100%；心包积液中分别为 25%、13.2%、35%、100%和 100%；腹腔积液中分别为 19.3%、10.4%、43.5%、100%和 100%。
胸腔积液、心包积液和腹腔积液细胞学检查在评估浆膜腔积液方面具有较高的特异性和中等敏感性。我们研究中报告的 ROM 与根据 TIS 发表的 ROM 大多一致。
